| Autor: |
Vecchione, Sarah, Johnson, Rhys, Matcovici, Melania, Stahlschmidt, Jens, Dawrant, Michael J., Alizai, Naved K. |
| Zdroj: |
Journal of Pediatric Endoscopic Surgery; 20240101, Issue: Preprints p1-8, 8p |
| Abstrakt: |
Purpose: Malignant change is a well-recognised risk of choledochal malformation (CM). Rhabdomyosarcoma (RMS) has been reported as a primary malignancy in children, which can cause biliary obstruction, mimicking CM. There are no reports describing RMS arising from a CM at a young age treated with minimally invasive approach (MIS). We describe the first case of this kind. The patient underwent robotic-assisted excision and hepaticojejunostomy. Methods: Patient records were reviewed. Literature search of MEDLINE, Web of science and CENTRAL was performed. Results: A 3-year-old female patient presented with obstructive jaundice and fever. Ultrasound and MRCP appearances suggested type 4a CM (Todani Classification), with ectatic intrahepatic ducts. There were unusual CM features, with the presence of sludge in the upper parts of the extra-hepatic biliary system, unresponsiveness to ursodeoxycholic acid and a non-distended gallbladder. Conclusions: To authors knowledge, this represents the first case report of a robotic excision of biliary tract RMS arising in a CM. It demonstrates the importance of a high index of suspicion in the presence of unusual features. Minimal-invasive approach can safely be considered in selected oncological cases. |
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